A Positive Healthshare Experience
I just wanted to share my experience with health sharing. I’m a business owner so I am in that zone where I don’t get an employer subsidizing traditional insurance for me and also ACA plans are full price and laughably expensive. So I have may family under a health sharing plan based on recommendations from some colleagues. They get a lot of bad rap around the internet so I wanted to share my experiences and recommendations, because they really can work, for the right people and situations.
In the past 12 months, both my son and I have had extended hospital stays including ER and ICU, and then my wife had twins which also required surgical early term birth followed by extended NICU stays. We basically went from 0 to 100 when it comes to health issues and bills were flying around everywhere.
The healthshare covered 100% of costs, minus the first $1000 per incident (up to 3 per year). The total costs were deep into 6 figures, and they were all covered without any haggle, even stuff like additional transport (a fucking ripoff at 15k each way) which the doctors said was rarely covered by insurance.
It’s a great feeling getting medical bills in the mail, and instead of stressing over it and having it ruin your day, taking a picture of it, uploading it, and it gets paid, or I get a virtual credit card to pay it.
PROS
Dirt cheap monthly, I pay $590 for a family of 5, effective yearly deductible of $3000. Craptastic marketplace plans were $1800 premium for me last I checked and that was just for the family of 3 now 5.
No networks, no balance bills, just show up anywhere and present for self pay. submit bills and they pay them. self pay bills are 50-80% discounted
Start right away, cancel right away, no waiting for open enrollment. Pre-existing conditions and pregnancy I think have a waiting period of something like 60 days or something but the rest starts from day 1.
KIND OF BUT NOT REALLY CONS
Generally no prescription coverage outside of incidents, but I find that GoodRX is often dirt cheap for anything we need anyway. Worth exploring based on your specific needs. It’s a good idea to take some of the premium savings you have and put it aside just in case.
You’re going to have to do some work when it comes to the billing, which means when you get bills, if they don’t have cash discounts or CPT codes, you have to call and ask for them. It’s the providers who generally suck here, their billing departments are always awful and lazy. However, it also means that I’m on top of everything, and there are no surprises out of the blue.
They don’t pay for certain things that generally are covered- but usually are cheap anyway. For example the hospital was all blown away when I said that breast pumps aren’t covered. A spectra S2 is $140 on amazon. I can live with that. I’m paying $600/mo not $1800+
Many are religious-based, but mine isn’t. May or may not be a con depending on you.
Providers can be stupid. “what’s your insurance”. Self pay. “can I see your insurance card?” I said self pay. “do you want to fill out Medicare forms” No
CONS
You have to know the guidelines back and forth, and be 100% understanding of and OK with them. I think a lot of the trouble occurs when people don’t do this and then get shocked when things aren’t covered. For example with mine, any incident that happens when under the influence of alcohol or drugs isn’t covered. Abortions aren’t covered. Allergy treatment isn’t covered for some reason. Very limited mental health coverage. stuff like that. You’re getting this at 1/4th monthly premium for a reason, it isn’t magic. Up to you if it works for your life situation or not.
They have no legal obligation. It’s a risk. But for me, it paid off in spades.
You have to keep on top of your choice of healthshare in case you need to bail. They legally have to release a form called 990 every year. I check it out every year to make sure they’re not spiraling into financial trouble like Liberty Healthshare did.
Hope this helps anyone looking for actual info from someone who (unfortunately) has had a ton of experience with them in the last 12 months. My specific healthshare is Zion Healthshare.
